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Flashcards in Upper Limb Deck (46):
1

Name the major parts of the scapula.

- coracoid process, acromion, glenoid fossa, spine, supraspinatus fossa, infraspinatus foss

2

Name the major parts of the humerus.

- head, anatomical and surgical necks, greater tubercle, lesser tubercle, intertubercular groove, deltoid tuberosity, spinal groove
- radial groove, coronoid fossa (for ulna in full flexion), olecranon fossa (for ulna in full extension)
- medial and lateral epicondyles
- capitulum, trochlea

3

Name the major parts of the ulna.

- trochlear notch, olecranon process, coronoid process
- head of ulna (distal! vs. proximal head of radius), styloid process of ulna

4

Name the major parts of the radius.

- head of radius (proximal! vs. distal head of ulna)
- styloid process of radius

5

What holds the forearm bones together?

- ulna and radius are held together by the ligaments at each end and also by the interosseus membrane between them

6

Name the bones of the carpus (the wrist).

- wrist in supination, lateral to medial: Some Lovers Try Positions That They Can't Handle
- proximal row (L to M): scaphoid, lunate, triquetrum, pisiform
- distal row (L to M): trapezium, trapezoid, capitate, hamate

7

What part of the metacarpals contains the head (the proximal or distal end)?

- the head of the metacarpals is found at the distal end

8

What are the major joints of the pectoral girdle? Which joint makes up the shoulder joint?

- sternoclavicular joint
- coracoclavicular joint
- acromioclavicular joint
- glenohumeral joint (shoulder joint)

9

What are the major ligaments of the pectoral girdle?

- coracoclavicular ligament (coronoid and trapezoid parts)
- coracoacromial ligament
- acromioclavicular ligament

10

What are the major ligaments of the shoulder joint?

- (there are MANY!)
- supraspinatus TENDON
- subscapularis TENDON
- capsular ligaments

11

In the elbow joint, what articulates with the humerus' trochlea? With the humerus' capitulum?

- trochlea: trochlear notch of ulna
- capitulum: radial head

12

What are the major ligaments of the elbow joint?

- anular ligament: from the ulna and wraps around the radial head
- radial and ulnar collateral ligaments
- joint capsule

13

What makes up the wrist joint?

- the distal end of the radius and the proximal row of the carpal bones
- (the ulnar is not directly involved, but it does have an articular disc at its head that contributes to the joint)

14

What are the major wrist ligaments?

- radial and ulnar collateral ligaments
- palmar radiocarpal ligament
- dorsal radiocarpal ligament

15

Where does the flexor retinaculum attach to? What is deep to it?

- (this is a ligamentous structure)
- it is attached to the scaphoid, pisiform, trapezium, and hamate carpal bones (these make up the four corners of the wrist!)
- deep to the flexor retinaculum is the carpal tunnel?

16

What passes through the carpal tunnel?

- the median nerve! (compression here leads to carpal tunnel syndrome)
- (the ulnar nerve, ulnar artery, and radial artery all pass outside the tunnel)

17

What are the major joints of the hand? What type of special joints are in the thumb?

- CMC joints: carpometacarpal joints
- MCP joints: metacarpophalangeal joints
- IP joints: interphalangeal joints (DIPs and PIPs)
- CMC joint of thumb: saddle joint
- MCP joint of thumb: ellipsoid joint

18

What are the pectoral girdle muscles? What is the origin and insertion of each?

- (these muscles mainly move the scapula)
- trapezius: occipital bone, ligamentum nuchae, T1-T12 (O); clavicle, acromion, scapular spine (I)
- serratus anterior: anterior aspect of ribs 1-8 (O); anterior medial border of scapula (I)
- pectoralis minor: anterior aspect of ribs 2-5 (O); coracoid process (I)
- rhomboid major: T1-T4 (O); posterior medial border of scapula (I)
- rhomboid minor: C7 (O); posterior medial border of scapula
- levator scapulae: C1-C4 (O); superior aspect of poster medial border of scapula (I)
- subclavius: rib 1 (O); clavicle (I)

19

Which nerves supply the muscles of the pectoral girdle?

- trapezius: CN XI (spinal part); NOT from the brachial plexus!
- serratus anterior: long thoracic nerve
- pectoralis minor: medial and lateral pectoral nerves
- rhomboids: dorsal scapular nerve
- levator scapula: dorsal scapular nerve
- subclavius: nerve to subclavius

20

Which muscles move the shoulder (not including the rotator cuff)?

- pectoralis major (adductor): medial clavicle, sternum, ribs 1-6 (O); bicipital groove of humerus (I)
- latissimus dorsi (adductor and extensor): T7-L5 (O); intertubercular groove of humerus (I)
- teres major (adductor and extensor): posterior aspect of inferior angle of scapula (O); intertubercular groove of humerus (I)
- deltoid: (abductor): clavicle and acromion (O); lateral aspect of humerus (I)
- coracobrachialis (flexor): coracoid process (O); medial 1/3 of humerus (I)

21

Which muscles make up the rotator cuff of the shoulder?

- (these muscles stabilize the shoulder; keeping the head of the humerus locked in; they all insert onto the tubercles of the humerus)
- subscapularis: anterior surface of scapula (O)
- supraspinatus: above the scapular spine (O)
- infraspinatus: below the scapular spine (O)
- teres minor: posterior aspect of inferior angle of scapula, above the teres major and below the infraspinatus (O)

22

Which nerves supply the muscles of the shoulder and the rotator cuff?

- pectoralis major: medial and lateral pectoral nerves
- lattisimus dorsi: thoracodorsal nerve
- teres major: lower subscapular nerve
- deltiod: axillary nerve
- corachobrachialis: musculocutaneous nerve
- subscapularis: subscapular nerves
- supraspinatus and infraspinatus: suprascapular nerve
- teres minor: axillary nerve

23

What are the muscles that make up the posterior compartment of the arm?

- (these mainly extend the arm)
- triceps brachii (long head): infraglenoid tubercle of scapula (O); olecranon process of ulna (I)
- triceps brachii (lateral head): upper end of humerus (O); olecranon process of ulna (I)
- triceps brachii (medial head): upper end of humerus (O); olecranon process of ulna (I) (*lies deep to the other two heads*)
- anconeus: lateral epicondyle of humerus (O); olecranon process of ulna (I)

24

Which nerves supply the muscles of the posterior compartment of the arm?

- the radial nerve
- (the raidal nerve supplies all posterior muscles of the arm and forearm!)

25

What are the muscles that make up the anterior compartment of the arm?

- (these are mainly flexors of the arm; biceps also supinate)
- biceps brachii (long head): supraglenoid tubercle of scapula (O); radial tuberosity (I)
- biceps brachii (short head): coracoid process of scapula (O); radial tuberosity (I)
- coracobrachialis: coracoid process (O); medial 1/3 of humerus (I)
- brachialis: anterior surface of distal humerus (O); coronoid process and tuberosity of ulna (I) (it lies deep to the biceps)

26

Which nerves supply the muscles of the anterior compartment of the arm?

- biceps brachii: musculocutaneous nerve
- coracobrachialis: musculocutaneous nerve
- brachialis: musculocutaneous nerve
- (musculocutaneous nerve supplies all muscles of the anterior arm - NOT the forearm)

27

What is the general grouping of the muscles of the forarm? What actions does each group perform?

- anteromedial group (anterior group); deep and superficial: flexion of wrist and fingers, pronation of forearm
- posterolateral group (posterior group); deep and superficial: extension of wrist and finger, supination of forearm

28

Which muscles make up the superficial layer of the anteromedial muscles of the forearm?

- (these are wrist and finger flexors, forearm pronators)
- they all originate from the MEDIAL epicondyle of the humerus (the common flexor tendon); from L to M:
- pronator teres (no flexor action): inserts onto the proximal radius
- flexor carpi radialis: inserts onto the palmar base of the 2nd metatarsal
- palmaris longus: inserts onto the palmar aponeurosis
- flexor carpi ulnaris: inserts onto the palmar base of the 5th metatarsal
- (remember "Pass, Fail, Pass, Fail")

29

Which muscles make up the intermediate layer of the anteromedial muscles of the forearm?

- (this is a wrist and finger flexor)
- flexor digitorum superficialis: lateral epicondule of humerus, middle aspect of radius (O); palmar aspect of middle phalanges of lateral 4 fingers (I)

30

Which muscles make up the deep layer of the anteromedial muscles of the forearm?

- (these are wrist and finger flexors, forearm pronators) from L to M:
- flexor pollicis longus: distal radius (O); palmar aspect of distal phalanx of pollex (I)
- flexor digitorum profundus: ulnar, radius, interosseus membrane (O); palmar aspect of distal phalanges of lateral 4 fingers (I)
- pronator quadratus (no flexor action): medial ulna (O); lateral radius (I) (deepest muscle, wraps "around" the distal ulna and radius)

31

Which nerves supply the anteriomedial muscles of the forearm?

- all are supplied by the median nerve, EXCEPT for the flexor carpi ulnaris and the medial part of the flexor digitorum profundus
- these two are supplied by the ulnar nerve

32

Which muscles make up the superficial layer of the posterolateral muscles of the forearm?

- (these are wrist and finger extensors, forearm supinators)
- most originate from the LATERAL epicondyle of humerus (the common extensor tendon); from L to M:
- brachioradialis: inserts onto distal end of radius (*this is a FLEXOR, not an extensor, but lies in the lateral compartment)
- extensor carpi radialis longus: inserts onto the dorsal base of the 2nd metatarsal
- extensor carpi radialis brevis: inserts onto the dorsal base of the 3rd metatarsal
- extensor digitorum: inserts onto the dorsal aspect of distal phalanges of lateral 4 fingers
- extensor digiti minimi: inserts onto the dorsal aspect of proximal phalanx of little finer
- extensor carpi ulnaris: inserts onto the dorsal base of the 5th metatarsal
- anconeus (pronator, also elbow extensor): lateral epicondyle of humerus (O); olecranon process of ulna (I)

33

Which muscles make up the deep layer of the posterolateral muscles of the forearm?

- (these are wrist and finger extensors, forearm supinators) from L to M:
- supinator (superficial and deep parts)
- abductor pollicis longus: ulna, radius, interosseus membrane (O); 1st metacarpal (I)
- extensor pollicis brevis: radius, interosseus membrane (O); proximal phalanx of pollex (I)
- extensor pollicis longus: ulna, interosseus membrane (O); distal phalanx of pollex (I)
- extensor indicis: ulna, interosseus membrane (O); distal phalanx of index finger (I)

34

Which nerves supply the muscles of the posterolateral compartment of the forearm?

- all are supplied by the radial nerve
- (all posterior muscles of the arm and forearm are supplied by the radial nerve)

35

Briefly explain the blood supply to the upper limb.

- subclavian artery becomes the axillary artery , which gives off a deep brachial branch (supplies the posterior arm) before continuing down the arm as the brachial artery
- at the level of the cubital fossa, the brachial artery bifuricates into the radial and ulnar arteries

36

Which structures lie in the cubital fossa?

- from L to M:
- biceps tendon
- brachial artery (just before it bifuricates into radial and ulnar arteries)
- median nerve

37

Briefly explain the venous drainage of the upper limb.

- the cephalic vein starts at the lateral wrist, while the basilic vein starts at the medial wrist
- these extend upwards on their respective sides (there is a median cubital vein that attaches the (lateral) cephalic to the (medial) basilic) and eventually drain into the subclavian vein
- before this junction, the basilic vein gets joined by the brachial vein to form the axillary vein (so axillary vein and cephalic vein join to form the subclavian vein)
- (the brachial vein drains the posterior aspects)

38

What are the basic parts of the brachial plexus?

- "(Should've) Read That Damn Cadaver Book"
- 5 spinal roots: C5-T1
- 3 trunks: superior (from C5-C6), middle (from C7), inferior (from C8-T1)
- 6 divisons: 3 anterior, 3 posterior (each trunk gives off 1 of each)
- 3 cords: lateral, posterior, medial
- 5 (terminal) branches (L to M): musculocutaneous, axillary, radial, median, ulnar

39

What are the nerve branches of the superior trunk?

- "the 3 S's of the Superior trunk"
- (1st S is from the Superior trunk)
- suprascapular nerve (C5,6)
- nerve to subclavius (C5,6)

40

What are the branches of the lateral cord?

- "LM(L)M"
- lateral pectoral (C5,6,7)
- musculocutaneous (C5,6,7)
- (lateral root) of median nerve ((C5-T1)

41

What are the branches of the posterior cord?

- "ULTRA"
- upper subscapular (C5,6)
- lower subscapular (C5,6)
- thoracodorsal (middle subscapular) (C6,7,8)
- radial (C5-T1)
- axillary (C5,6)

42

What are the branches of the medial cord?

- "M4U"
- medial pectoral (C8,T1)
- medial brachial cutaneous (T1)
- medial antebrachial cutaneous (C8,T1)
- (medial root) of median nerve (C5-T1)
- ulnar (C7-T1)

43

Where does the long thoracic nerve arise from? What about the dorsal scapular nerve?

- long thoracic: the spinal roots of C5, C6, and C7
- dorsal scapular: C5

44

Which muscles does the dorsal scapular nerve supply? The long thoracic nerve? Nerve to subclavius? Suprascapular nerve?

- dorsal scapular: levator scapulae and the rhomboids
- long thoracic: serratus anterior
- nerve to subclavius: subclavius
- suprascapular: supraspinatus, infraspinatus

45

Which muscles does the pectoralis nerves supply? The subscapular nerves? The thoracodorsal nerve?

- pectoralis: pectoralis major and minor
- subscapular: subscapularis, teres major
- thoracodorsal nerve: latissimus dorsi

46

Which muscles does the musculocutaneous nerve supply? The axillary nerve? Radial nerve? Median nerve? Ulnar nerve?

- musculocutaneous: muscles of the anterior arm (corachobrachialis, biceps brachii, brachialis)
- axillary: teres minor, deltoid
- radial: all poster muscles of arm and forearm
- median: all anterior muscles of the forearm except those supplied by the ulnar nerve
- ulnar: flexor carpi ulnaris, medial 1/2 of flexor digitorum profundus